眼外伤球内后段异物的手术处理  

Surgical management for ocular trauma with posterior intra-ocular foreign bodies

作　　者：游向东 金中秋 陈晓 周和政 王柏川 

机构地区：[1]南京军区第175中心医院眼科,福建漳州363000

出　　处：《创伤外科杂志》2005年第2期100-101,共2页Journal of Traumatic Surgery

摘　　要：目的　评价眼外伤球内后段异物的玻璃体切割术摘除法及后径摘除法的效果及影响因素。方法　本组眼外伤球内后段异物共 6 2例 (6 2眼 ) ,其中 32例行玻璃体切割术联合异物摘除术 ,30例行外伤后初期清创缝合联合后径异物取出术 ,前者采用常规睫状体平坦部三切口闭合式玻璃体切割 ,联合白内障晶状体切除或硅油填充或全氟丙烷 (C3 F8)气体填充或巩膜外加压术或环扎术 ,异物经前房或睫状体平坦部用异物镊夹出 ;后者异物的定位后从巩膜切口取出。结果　玻璃体切割术组异物取出率 10 0 %;后径取出术组异物取出率 86 .6 7%(2 6 / 30 )。术后视力 :玻璃体切割术组提高或不变 2 5例 ,下降 7例 ;后径取出术组提高或不变 13例 ,下降 17例。结论　玻璃体切割术可以准确有效地取出各种异物 ,而且损伤小 ,能最大限度地恢复视功能。后径取出术适合异物较小、晶状体玻璃体透明者。Objective To evaluate the effectiveness and the influence factors of surgical management on posterior intra-ocular foreign bodies(PIOFBs) removal.Methods The clinical data of 62 cases(62eyes) of PIOFBs were reviewed retrospectively.The PIOFBs were removed by external pathway in 30 cases,while a pars plana vitrectomy plus PIOFBs extraction was performed with lensectomy,IOL implantation,encircling,silicone oil and C 3 F 8 injection in another 32 cases.Results The successful rate of the extraction of PIOFBs was 100% in the group of vitrectomy,and 86.67% in the group of external pathway.The follow-up was more than 6 months.Post-operative VA(visual acuity) or unchanged was found in 25 and became worse in 7 cases in the group of vitrectomy,post-operative VA improved or unchanged was observed in 13 and 17 cases respectively in the group of external pathway.Conclusion Vitrectomy treatment for posterior intra-ocular foreign bodies removal is effectve with less injury,and postoperative VA can be improved as high as possible.Extraction of PIOFBs via exteral pathyway is effective for small foreign bodies,transparency lens,mild vitreous hemorrhage.

关 键 词：眼损伤 异物摘除术 玻璃体切割术 

分 类 号：R779.1[医药卫生—眼科]